Monday, April 17, 2017

Today's guest post comes from long-time reader Sarah Trend who shared with me the handout she received on leaving her most recent endocrinology appointment. She also provided me with her thoughts and kindly agreed to let me share them with you. All this to say, if you're an MD the only thing your patient's weight tells you is the gravitational pull of the earth on them at a given moment in time. It tells you nothing about the presence or absence of health, nor does it tell you anything about their lifestyles. And if you're planning on providing lifestyle related advice, best you explore your patients' actual lifestyles first - regardless of their weights. Plenty of people with higher weights have incredibly healthful lifestyles, and many people with lower weights live awfully unhealthy lives.

I went to the endocrinologist this morning. The PA had me step on the scale and she recorded my weight. There was no discussion whatsoever with her or with the doctor about my weight. Imagine my surprise when I reviewed the "follow up" instructions - photo attached.

For the record, I weigh about 5 lb more than their "long term goal weight". I am 5'8". Had there been any discussion whatsoever, the doctor would have learned that the "weight loss tips" are not of much value to me: I only drink water. I do not eat fast food. I eat breakfast (hard-boiled egg and some fruit) every morning. I watch, at most, one 30-minute TV show a day. My husband does all grocery shopping. We cook >95% of our meals at home (from scratch, not boxes) and I take leftovers for lunch every day. Many of these meals are vegetarian. I get 4-5 hours of vigorous exercise every week - in fact, before my appointment I ran 3.25 miles at a pace of 9:22/mile. I only take the stairs at work. I get >10K steps each day.

Also, my blood pressure, as taken by his PA in the appointment, is 91/56.

So yes, I would really like to lose 10-15 vanity pounds, but that is all they are - vanity pounds. And yes, my weight is a few pounds above a BMI of 25. Had he had a conversation with me, he would have learned that I worked 61 straight 12-16 hour days at the start of this year. Some days, yeah, I grabbed a bag of peanut M&Ms or skittles from the snack cupboard in the office. Because I'm a human. And also - my period is due, so I'm up about 3 pounds of water weight from that.

I am so angry. Is this what passes for medical advice now? Meaningless random comments about weight loss with no conversation about health? I am appalled that an endocrinologist (who presumably sees patients with a variety of weight issues) thinks this is appropriate. Thought you might like to see it.

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About Me

Family doc, Assistant Prof. at the University of Ottawa, Author of The Diet Fix, and founder of Ottawa's non-surgical Bariatric Medical Institute - a multi-disciplinary, ethical, evidence-based nutrition and weight management centre. Nowadays I'm more likely to stop drugs than start them. You can also find me on Twitter and Facebook.

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